Individual
JENNIFER A NIEDERSTADT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, MILWAUKEE, WI 53215-3669
(414) 649-3370
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2280
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2059-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43999000
—
WI
Enumeration date
04/11/2007
Last updated
02/26/2025
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